| NPI | 1396520680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARESE ABDUL KALEEM Dietitian 405-413-8227 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2023-08-28 |
| Last Update Date | 2023-08-29 |